Correlation of chest radiographic findings and coagulation abnormality with disease severity in COVID-19 positive patients
Introduction: The pandemic of coronavirus disease 19 (COVID-19) has engulfed most of the world and has constrained already overburdened health care systems, especially in developing countries. There is an urgent need of a rapid investigation to assess disease severity in suspected patients and the b...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Acta Medica International |
| Subjects: | |
| Online Access: | http://www.actamedicainternational.com/article.asp?issn=2349-0578;year=2021;volume=8;issue=2;spage=155;epage=162;aulast=Aggarwal |
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| author | Yogender Aggarwal Ankur Malhotra Deepti Arora Shruti Chandak Ashutosh Kumar Vivek Bhandari |
| author_facet | Yogender Aggarwal Ankur Malhotra Deepti Arora Shruti Chandak Ashutosh Kumar Vivek Bhandari |
| author_sort | Yogender Aggarwal |
| collection | DOAJ |
| description | Introduction: The pandemic of coronavirus disease 19 (COVID-19) has engulfed most of the world and has constrained already overburdened health care systems, especially in developing countries. There is an urgent need of a rapid investigation to assess disease severity in suspected patients and the baseline chest radiograph may serve as a triage tool. The aim is to correlate chest radiographic findings and coagulation abnormality with disease severity in COVID-19 positive patients. Materials and Methods: This was a retrospective observational study which comprised 100 reverse transcription-polymerase chain reaction positive COVID-19 cases which were clinically stratified into three groups based on clinical parameters. Baseline chest radiograph and serum D-dimer levels at the time of admission for all the patients were reviewed. A radiographic severity score (Radiographic Assessment of Lung Edema [RALE]) was determined for all four quadrants of both lungs. The scores of each quadrant were added to yield the final severity score. Results: Baseline chest radiograph was abnormal in 75% of patients, whereas 25% of patients had normal chest radiograph. Most frequent radiographic abnormality was ground-glass opacity (GGO) (n = 31, 41.3%) followed by lung consolidation (n = 19, 25.3%), while 7 patients (9.3%) had both GGO and consolidation. The most common pattern of disease distribution was bilateral 34 (57.7%) and peripheral in 58 (69%). The optimal cut-off RALE score for identifying symptomatic patients was ≥3 (area under the curve [AUC] 0.760) and for identifying severe cases was ≥7 (AUC 0.870). Similarly, the optimal cut-off D-Dimer value for identifying symptomatic patients was ≥567 ng/ml (AUC 0.836) and for diagnosing severe disease was ≥1200 ng/ml (AUC 0.99). Conclusions: Radiographic RALE score and elevated serum D-Dimer levels correlate strongly with disease severity in COVID-19 patients and can be utilized for early identification of high-risk cases which can ultimately reduce mortality and morbidity. |
| first_indexed | 2024-04-11T20:40:39Z |
| format | Article |
| id | doaj.art-6277bf81c3cf43d69a0a3b5439f1be9b |
| institution | Directory Open Access Journal |
| issn | 2349-0578 2349-0896 |
| language | English |
| last_indexed | 2024-04-11T20:40:39Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Acta Medica International |
| spelling | doaj.art-6277bf81c3cf43d69a0a3b5439f1be9b2022-12-22T04:04:13ZengWolters Kluwer Medknow PublicationsActa Medica International2349-05782349-08962021-01-018215516210.4103/amit.amit_27_21Correlation of chest radiographic findings and coagulation abnormality with disease severity in COVID-19 positive patientsYogender AggarwalAnkur MalhotraDeepti AroraShruti ChandakAshutosh KumarVivek BhandariIntroduction: The pandemic of coronavirus disease 19 (COVID-19) has engulfed most of the world and has constrained already overburdened health care systems, especially in developing countries. There is an urgent need of a rapid investigation to assess disease severity in suspected patients and the baseline chest radiograph may serve as a triage tool. The aim is to correlate chest radiographic findings and coagulation abnormality with disease severity in COVID-19 positive patients. Materials and Methods: This was a retrospective observational study which comprised 100 reverse transcription-polymerase chain reaction positive COVID-19 cases which were clinically stratified into three groups based on clinical parameters. Baseline chest radiograph and serum D-dimer levels at the time of admission for all the patients were reviewed. A radiographic severity score (Radiographic Assessment of Lung Edema [RALE]) was determined for all four quadrants of both lungs. The scores of each quadrant were added to yield the final severity score. Results: Baseline chest radiograph was abnormal in 75% of patients, whereas 25% of patients had normal chest radiograph. Most frequent radiographic abnormality was ground-glass opacity (GGO) (n = 31, 41.3%) followed by lung consolidation (n = 19, 25.3%), while 7 patients (9.3%) had both GGO and consolidation. The most common pattern of disease distribution was bilateral 34 (57.7%) and peripheral in 58 (69%). The optimal cut-off RALE score for identifying symptomatic patients was ≥3 (area under the curve [AUC] 0.760) and for identifying severe cases was ≥7 (AUC 0.870). Similarly, the optimal cut-off D-Dimer value for identifying symptomatic patients was ≥567 ng/ml (AUC 0.836) and for diagnosing severe disease was ≥1200 ng/ml (AUC 0.99). Conclusions: Radiographic RALE score and elevated serum D-Dimer levels correlate strongly with disease severity in COVID-19 patients and can be utilized for early identification of high-risk cases which can ultimately reduce mortality and morbidity.http://www.actamedicainternational.com/article.asp?issn=2349-0578;year=2021;volume=8;issue=2;spage=155;epage=162;aulast=Aggarwalchest radiographcovid-19d-dimerradiographic assessment of lung edema scoresevere disease |
| spellingShingle | Yogender Aggarwal Ankur Malhotra Deepti Arora Shruti Chandak Ashutosh Kumar Vivek Bhandari Correlation of chest radiographic findings and coagulation abnormality with disease severity in COVID-19 positive patients Acta Medica International chest radiograph covid-19 d-dimer radiographic assessment of lung edema score severe disease |
| title | Correlation of chest radiographic findings and coagulation abnormality with disease severity in COVID-19 positive patients |
| title_full | Correlation of chest radiographic findings and coagulation abnormality with disease severity in COVID-19 positive patients |
| title_fullStr | Correlation of chest radiographic findings and coagulation abnormality with disease severity in COVID-19 positive patients |
| title_full_unstemmed | Correlation of chest radiographic findings and coagulation abnormality with disease severity in COVID-19 positive patients |
| title_short | Correlation of chest radiographic findings and coagulation abnormality with disease severity in COVID-19 positive patients |
| title_sort | correlation of chest radiographic findings and coagulation abnormality with disease severity in covid 19 positive patients |
| topic | chest radiograph covid-19 d-dimer radiographic assessment of lung edema score severe disease |
| url | http://www.actamedicainternational.com/article.asp?issn=2349-0578;year=2021;volume=8;issue=2;spage=155;epage=162;aulast=Aggarwal |
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